Perspectives of wheelchair users with spinal cord injury on fall circumstances and fall prevention: A mixed methods approach using photovoice

• Published in: PloS one 2020-08, Vol.15 (8), p.e0238116-e0238116
• Main Authors: Singh, Hardeep, Scovil, Carol Y, Bostick, Geoff, Kaiser, Anita, Craven, B. Catharine, Jaglal, Susan B, Musselman, Kristin E
• Format: Article
• Language: English
• Subjects: Accidental falls; Accidents; Beliefs, opinions and attitudes; Biology and Life Sciences; Care and treatment; Earth Sciences; Engineering and Technology; Falls; Health aspects; Health care networks; Health risks; Injury prevention; Intervention; Life span; Medicine; Medicine and Health Sciences; Methods; Mixed methods research; Physical therapy; Physically disabled persons; Polls & surveys; Prevention; Rehabilitation; Research and Analysis Methods; Risk factors; Social Sciences; Spinal cord injuries; Trends; Wheelchairs
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0238116

Wheelchair users with spinal cord injury are at a high risk of falls. However, the perspectives of wheelchair users with spinal cord injury on their fall circumstances and their preferences for fall prevention strategies/interventions remain understudied. Therefore, we aimed to: a) describe the circumstances of falls experienced by wheelchair users with spinal cord injury over a six-month period, b) explore their perspectives of why falls occurred in certain situations, and c) explore their perspectives on recommended content/structure of fall prevention strategies/interventions. This sequential explanatory mixed methods study had two phases. Phase I involved tracking of falls experienced by wheelchair users with spinal cord injury over six months, in which participants completed a survey after experiencing a fall to track the number/circumstance of each fall. Data from the surveys were descriptively reported. Phase II involved a photovoice focus group discussion of the survey findings and their preferences for fall prevention strategies/interventions. Data from the focus group discussion were analyzed using a thematic analysis. Thirty-two participants completed phase I. More than half of the participants fell at least once in six months. Falls commonly occurred in the afternoon during a transfer, or when participants were wheeling over uneven ground. One-third of the falls caused an injury. Eleven participants that fell during phase I participated in the focus group. Two main themes were identified from the discussion: 1) "circumstances surrounding the falls" (e.g. when falls occurred, the home is a 'safe space') and 2) "suggestions and preferences for fall prevention strategies/interventions" (e.g. fall prevention involves all, fall prevention training available as needed). Fall prevention strategies/interventions should be an integral component of rehabilitation practices across the lifespan. Participants recommend customizing fall prevention strategies/interventions to their specific needs to guide the structure, content, and delivery of targeted fall prevention programs.